Skip to main content

Advertisement

Log in

Significance of nipple enhancement of Paget’s disease in contrast enhanced breast MRI

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To evaluate significance of nipple enhancement of Paget’s disease in contrast enhanced (CE) breast MRI.

Methods

Ten patients of biopsy proven Paget’s disease were included in this study. Preoperative mammogram and ultrasonogram (US) were obtained in all 10 patients, and 8 patients underwent CE breast MRI prior to surgery. Mammographic and US findings were reviewed retrospectively. On MRI, morphology (flattening or asymmetry or thickening) and enhancement of pathologically involved nipple were analyzed comparing with the opposite side, and also reviewed the abnormal enhancing lesion in the breast parenchyma.

Results

Morphologic changes of the nipple were detected in 2 out of 10 patients by mammogram and 6 out of 10 patients by US. On MRI, morphologic change was also revealed in 7 patients and abnormal enhancement of involved nipple was observed in all 8 patients. Associated parenchymal enhancing lesions were proved to be DCIS (7 out of 10) and invasive ductal carcinoma (2 out of 10). Remaining one patient had no underlying breast parenchymal malignancy.

Conclusion

CE breast MRI allows for the correct detection of nipple involvement of Paget’s disease even when clinical information or mammographic/US findings are not provided.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Burke ET, Braeuning MP, McLelland R, Pisano ED, Cooper LL (1998) Paget disease of the breast: a pictorial essay. Radiographics 18:1459–1464

    CAS  PubMed  Google Scholar 

  2. Frei KA, Bonel HM, Pelte MF, Hylton NM, Kinkel K (2005) Paget disease of the breast: findings at magnetic resonance imaging and histopathologic correlation. Invest Radiol 40:363–367

    Article  PubMed  Google Scholar 

  3. Sakorafas GH, Blanchard DK, Sarr MG, Farley DR (2001) Paget’s disease of the breast: a clinical perspective. Langenbeck’s Arch Surg 386:444–450. doi:10.1007/s004230100250

    Article  CAS  Google Scholar 

  4. Echevarria JJ, Lopez-Ruiz JA, Martin D, Imaz I, Martin M (2004) Usefulness of MRI in detecting occult breast cancer associated with Paget’s disease of the nipple-areolar complex. Br J Radiol 77:1036–1039. doi:10.1259/bjr/94607773

    Article  CAS  PubMed  Google Scholar 

  5. Sakorafas GH, Blanchard K, Sarr MG, Farley DR (2001) Paget’s disease of the breast. Cancer Treat Rev 27:9–18. doi:10.1053/ctrv.2000.0203

    Article  CAS  PubMed  Google Scholar 

  6. Caliskan M, Gatti G, Sonovskikh I et al (2008) Paget’s disease of the breast: the experience of the European institute of oncology and review of the literature. Breast Cancer Res Treat 112:513–521. doi:10.1007/s10549-007-9880-5

    Article  PubMed  Google Scholar 

  7. Ikeda DI, Helvie MA, Frank TS, Chapel KL, Andersson IT (1993) Paget disease of nipple: radiologic–pathologic correlation. Radiology 189:89–94

    CAS  PubMed  Google Scholar 

  8. Jamali FR, Ricci A, Deckers PJ (1996) Paget’s disease of nipple-areola complex. Surg Clin North Am 76:365–381

    Article  CAS  PubMed  Google Scholar 

  9. Mitchell S, Lachica R, Randall MB, Beech DJ (2006) Paget’s disease of the breast areola mimicking cutaneous melanoma. Breast J 12(3):233–236

    Article  PubMed  Google Scholar 

  10. Morrogh M, Morris EA, Liberman L, Van Zee K, Cody HS III, King TA (2008) MRI identifies otherwise occult disease in select patients with Paget disease of the nipple. J Am Coll Surg 206:316–321. doi:10.1016/j.jamcollsurg.2007.07.046

    Article  PubMed  Google Scholar 

  11. Amano G, Yajima M, Moroboshi Y, Kuriya Y, Ohuchi N (2005) MRI accurately depicts underlying DCIS in a patient with Paget’s disease of the breast without palpable mass and mammography findings. Jpn J Clin Oncol 35:149–153. doi:10.1093/jjco/hyi044

    Article  PubMed  Google Scholar 

  12. Zakaria S, Pantvaidya G, Ghosh K, Degnim AC (2007) Paget’s disease of the breast: accuracy of preoperative assessment. Breast Cancer Res Treat 102:137–142. doi:10.1007/s10549-006-9329-2

    Article  PubMed  Google Scholar 

  13. Paone JF, Baker RR (1981) Pathogenesis and treatment of Paget’s disease of the breast. Cancer 48:825–829

    Article  CAS  PubMed  Google Scholar 

  14. Kothari AS, Beechey-Newman N, Hamed H, Fentiman IS, D’Arrigo C, Hanby AM, Ryder K (2002) Paget disease of the nipple: a multifocal manifestation of higher-risk disease. Cancer 95:1–7. doi:10.1002/cncr.10638

    Article  PubMed  Google Scholar 

  15. Günhan-Bilgen I, Oktay A (2006) Paget’s disease of the breast: clinical, mammographic, sonographic and pathologic findings in 52 cases. Eur J Radiol 60:256–263. doi:10.1016/j.ejrad.2006.06.010

    Article  PubMed  Google Scholar 

  16. Capobianco G, Spaliviero B, Dessole S, Cherchi PL, Marras V, Ambrosini G et al (2006) Paget’s disease of the nipple diagnosed by MRI. Arch Gynecol Obstet 274:316–318. doi:10.1007/s00404-006-0160-0

    Article  PubMed  Google Scholar 

  17. Friedman EP, Hall-Craggs MA, Mumtaz H, Schneidau A (1997) Breast MR and the appearance of the normal and abnormal nipple. Clin Radiol 52:854–861

    Article  CAS  PubMed  Google Scholar 

  18. Buadu AA, Buadu LD, Murakami J, Murayama S, Hashiguchi N, Masuda K (1998) Enhancement of the nipple-areolar-complex on contrast-enhanced MR imaging of the breast. Breast Cancer 5:285–289

    Article  PubMed  Google Scholar 

  19. Da Costa D, Taddese A, Cure ML, Gerson D, Poppiti R Jr, Esserman LE (2007) Common and usual diseases of the nipple areolar complex. Radiographics 27:S65–S77

    Article  PubMed  Google Scholar 

  20. Bijker N, Rutgers EJT, Duchateau L, Peterse JL, Julien JP, Cataliotti L (2001) Breast-conserving therapy for Paget disease of the nipple. Cancer 91:472–477

    Article  CAS  PubMed  Google Scholar 

  21. Chen CY, Sun LM, Anderson BO (2006) Paget disease of the breast: changing patterns of incidence, clinical presentation, and treatment in US. Cancer 107:1448–1458. doi:10.1002/cncr.22137

    Article  PubMed  Google Scholar 

Download references

Conflict of interest statement

We declare that we have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Eun Suk Cha.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kim, H.S., Seok, J.H., Cha, E.S. et al. Significance of nipple enhancement of Paget’s disease in contrast enhanced breast MRI. Arch Gynecol Obstet 282, 157–162 (2010). https://doi.org/10.1007/s00404-009-1244-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-009-1244-4

Keywords

Navigation